CAMBODIA H1N1 UPDATE #3: 9 CONFIRMED CASES

UNCLAS SECTION 01 OF 02 PHNOM PENH 000490 SENSITIVE SIPDIS STATE FOR EAP/MLS, G/AIAG, OES/IHA, MED STATE FOR USAID/ANE, OFDA AND GH BANGKOK FOR REO/HHOWARD BANGKOK FOR OFDA CDC FOR NCIRD/NCOX, JBRESE, TMOUNTS E.O. 12958: N/A TAGS: KFLU AEMR ASEC CASC KFLO TBIO KSAF KPAO PREL PINR AMGT, MG, EAGR, CB SUBJECT: CAMBODIA H1N1 UPDATE #3: 9 CONFIRMED CASES REF: A) PHNOM PENH 421, B) PHNOM PENH 272 ¶1. (SBU) SUMMARY. There are currently a total of nine cases of laboratory-confirmed novel influenza A (H1N1) in Cambodia. Post's U.S. Centers for Disease Control and Prevention (CDC) office is waiting for laboratory results on a potential tenth case from Institut Pasteur in Cambodia (IPC). All four new confirmed cases, one of which included an Embassy employee, had mild to moderate illnesses at worst, and the patients have all recovered. The Cambodian Ministry of Health's (MOH's) response has so far been adequate. Health officials are prepared to see more cases confirmed in more populated areas of the country over the course of Cambodia's flu season (June-November/December). CDC is working with the MOH to implement a severe acute respiratory infection surveillance system. END SUMMARY. CASE UPDATES -------------- ¶2. (SBU) The first confirmed case since Ref A was a 19-year-old Cambodian female with no travel history who was exposed through a personal contact, an Australian man who visited from Vietnam and tested positive for H1N1 upon his return to Vietnam. The second case was a 58-year-old Cambodian female with onset one to two days after returning from Thailand. Cambodian Ministry of Health (MOH) screeners at the Phnom Penh International Airport detected the third case, a 15-year-old Australian female who arrived on a flight from Bangkok. ¶3. (SBU) The fourth case was a 34-year-old male Embassy employee who reported to the Embassy medical unit on July 7 with complaints of fever, sore throat, rhinorrhea, and chills that had started the day before. The patient had a positive QuickVue Rapid test for influenza A and was started on Tamiflu for five days and remained in isolation at his home until seven days after the onset of his illness. He has since recovered and returned to work. A second patient with mild flu symptoms reported to the Embassy medical unit on July 8 but tested negative for influenza A using the QuickVue Rapid test. He made a full recovery when rechecked on July 13 after 7 days of voluntary isolation. CDC is waiting for results to confirm whether or not the second Embassy patient had H1N1. ¶4. (SBU) Acting Management Officer distributed a management notice July 8 following initial detection of H1N1 in the Embassy employee. The notice outlined common flu symptoms, procedures if an employee or family member displays flu symptoms, and guidelines for staying healthy, such as frequent hand-washing and keeping common surfaces clean. The Community Liaison Officer forwarded the notice to Embassy family members. CAMBODIAN GOVERNMENT RESPONSE TO DATE -------------- ¶5. (SBU) The MOH's response has so far been adequate. The MOH has: 1) increased influenza-like illness (ILI) surveillance at all MOH sites nationwide; 2) coordinated with Calmette and other designated H1N1 referral hospitals in Phnom Penh on proper specimen collection, isolation, and clinical management procedures for suspect and confirmed cases; 3) worked with Institut Pasteur to assure that all confirmatory laboratory test results are promptly and accurately reported; and 4) aggressively investigated all suspect and confirmed cases, as well as their exposed contacts. The MOH and the UN have developed public awareness ads on H1N1 for television, which have been broadcasting on six to seven channels since June. H1N1 FORECAST FOR CAMBODIA -------------- ¶6. (SBU) Cambodia has remained relatively isolated from the H1N1 outbreak so far, as it is somewhat removed from major travel routes. However, health officials are prepared to see more cases confirmed in more populated areas of the country over the course of Cambodia's flu season, which begins in June, peaks in September-October, and declines in November-December. CDC notes that health officials are likely not detecting all cases in the country due to the mild nature of the disease so far. CDC has developed and is leading the implementation of a severe acute respiratory infection surveillance system for MOH in some hospitals. This new surveillance system will PHNOM PENH 00000490 002 OF 002 hopefully help identify influenza activity among hospitalized patients. RODLEY